Benchmarks’ Partnering for Excellence (PFE) project works to align local private providers, LME/MCO partners, and local Departments of Social Services, as well as the community to better address the trauma-related needs of children and families encountering the child welfare system. Research shows that addressing trauma early on is imperative to bettering the outcomes of those who have experienced it. With so many children and families having trauma exposure, we recognized a need to implement a more trauma-informed approach to the assessment of children involved in the child welfare system. As a result, Benchmarks developed the Trauma-intensive Comprehensive Clinical Assessment (TiCCA) which aims to assist professionals and caregivers alike gain a better understanding of children’s trauma-related needs.
The TiCCA can take close to 12 hours to complete, involves an array of measures, and requires the clinician to go through a specialized TiCCA training before they can administer the assessment. When the PFE project went live in Pitt and Craven counties in 2020, the partnership was faced with unique roadblocks including the COVID-19 pandemic, Medicaid transformation, and FFPSA. Without the dedication and commitment of our partners, the project may have been difficult to lift. One of our three private providers, Pamlico Child and Family Therapy (PCFT) has not only been committed to making the PFE project successful but has also committed to support the trauma-related needs within the community.
Despite the many challenges facing the project due to system and policy changes, PCFT has seen a great benefit from the partnership. Stephanie Scott, lead director of PCFT, and PFE team lead at the agency, is excited to add another TiCCA clinician to the project this spring. She states that conducting TiCCAs not only provides children with a wonderful trauma assessment but has also changed the ways she conducts assessments and supervision. “There are several measures used when conducting a TiCCA, and since I began [TiCCAs], I have been able to incorporate some of those measures with other assessments and have found it really helps identify the needs of families.” She also shared how the project’s embedded CQI process has been beneficial for her team’s growth. She shared, “The feedback we get from clinical coaches has been very enlightening and has helped me write regular assessments as well as give stronger feedback to my clinicians when they are in supervision with me.” Most importantly, Stephanie states, “While completing a TiCCA is time-consuming, I am getting the whole picture of a child’s life and experience. When I complete a TiCCA, [I can] address the entire child versus when I conduct a regular CCA…Being a part of PFE and conducting TiCCAs has also pushed me to ask questions that I may not have asked before.”
In addition to adding TiCCAs to the services the agency provides, PCFT has worked diligently to increase other trauma-informed services the agency provides to the community as well. Recognizing there are limited trauma-informed therapists in the area, PCFT recently graduated two therapists from the NCTTP TF-CBT collaborative while also striving to offer an array of evidence-based trauma treatments including TF-CBT, EMDR, DBT, and trauma-informed SA treatment. Since going through the TF-CBT Collaborative, the agency has also updated their intake form to include the trauma checklist and ACEs questionnaire to better screen for trauma during the intake process. PCFT works to promote a more trauma-informed community outside of the practice as well, “We recognized that there is still a gap in the way trauma is understood and addressed in the area. Not everyone in the school system is trauma informed, so we collaborate with them on education and have also been excited to invite community members to trauma trainings hosted by Benchmarks in hopes to bridge that gap in understanding” says Scott.
PCFT is also navigating the changes associated with Medicaid Transformation and the Families First Prevention Services Act (FFPSA). Despite the difficulties of transitioning into the updated Medicaid world, PCFT has worked hard to contract with all five of the new Primary Health Plans (PHPs) to ensure their services are accessible to those who need them. “It can be difficult to make progress when trying to communicate rates and figure out billing, and it all seems like it is still up in the air, but we are going everything we can do to make it work” says Stephanie. While PCFT has not noticed a huge shift in their practice regarding FFPSA, they are excited to continue referring for the FFPSA services such as Multisystemic Therapy, Triple P, Parents as Teachers, and Home Builders.
We at Benchmarks love the opportunity to highlight those working on the front lines to address the trauma-informed needs in our community and cannot thank our partners like Pamlico Child and Family Therapy enough for all that they do!